Presence of Bacterial Infection
in Patients with Acute Haemorrhage Due to Portal Hypertension - the Authors´ Experience
Husová L.1, Lata J.1, Šenkyřík M.1, Juránková J.2, Husa P.3
1Interní gastroenterologická klinika FN Brno, pracoviště Bohunice, přednosta prof. MUDr. Petr Dítě, DrSc. 2Mikrobiologické oddělení FN Brno, pracoviště Bohunice, přednosta prim. MUDr. Alena Ševčíková3Klinika infekčních chorob, FN Brno, pracoviště Bohunice, přednosta doc. MUDr. Pavel Chalupa, CSc. |
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Summary:
Acute haemorrhage from the upper gastrointestinal tract is a frequent and serious complication
which affects 20 - 60 % patients with cirrhosis of the liver and portal hypertension. It is assumed
that bacterial infections can be the direct cause of haemorrhage but accurate data on the influence
of infection on the development and course of haemorrhage are lacking. Acute haemorrhage as
a result of portal hypertension has a very high mortality, 30-50 %, and an early relapse of haemorrhage
occurs in as many as 40 % of these patients. Most recent meta-analyses indicate that bacterial
infection is an independent prognostic factor in failure of haemostasis and has a significant
impact on the mortality of these patients. The authors examined for the presence of bacterial
infection (blood, urine, throat, ascites) 25 patients with cirrhosis of the liver and acute haemorhage
as a result of portal hypertension and compared the results with a group of 25 patients with
cirrhosis of the liver and portal hypertension without acute haemorrhage. According to the results
in patients with acute haemorrhage due to portal hypertension there is a significantly
higher incidence of bacterial infections than in patients with cirrhosis of the liver and portal
hypertension without acute haemorrhage. The results confirm the necessity to administer antibiotic
prophylaxis to cirrhotic patients with varicose bleeding, not only to patients with symptoms
and evidence of infection but also in their absence. Antibiotic prophylaxis extends the survival
period of these patients.
Key words:
Bacterial infection - Varicose haemorrhage - Portal hypertension
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